Development of a Model for Glycated Hemoglobin (HbA1C) Control in Diabetic Patients at Ban Baeg Health Promoting Hospital, Nathong Subdistrict, Chiang Yuen District, Maha Sarakham Province

Abstract

Abstract

            Objective : To study the problem situation and develop a model for glycated hemoglobin (HbA1c) control in diabetic patients at Ban Baeg Health Promoting Hospital.

            Methods : This participatory action research (PAR) was conducted from October 2023 to September 2024 in three phases: 1) Preparation : Situational analysis via focus groups, participant observation, and data review. 2) Development : Model development using two PAOR cycles with a target group of 75 diabetic patients (HbA1c ≥ 7%) and 180 stakeholders (relatives, Village Health Volunteers, role models). 3) Evaluation : Data were collected using qualitative (in-depth interviews, focus groups, medical records) and quantitative (HbA1c results, My PCU data) methods. Qualitative data were analyzed using content analysis and triangulation, while quantitative data were analyzed using descriptive statistics.

            Results : Most patients were female (86.74%) and aged 60 or older (71.70%). Key challenges included dietary habits (sticky rice, sweets), self-adjustment of medication, and lack of exercise. The BAC Model was developed, comprising : 1) Buddy : VHVs as "disease buddies," 2) Access to problems : Individualized needs assessment, and 3) Care management : Utilizing Motivational Interviewing (MI), self-care promotion, and establishing a "Diabetes School." Post-intervention, HbA1c levels decreased in 89.33% of patients, with 73.33% achieving the target of HbA1c < 7%. Positive changes in other health indicators, such as reduced waist circumference and improved blood pressure control (in 84 % of patients), were also observed.

            Conclusion : The community-based BAC Model effectively enhanced motivation and facilitated behavior change, leading to significant improvements in glycemic control. The initiative resulted in sustainable social innovations, including the "Diabetes School" and robust community health networks, fostering overall well-being.

Keywords : Model Development, Glycated Hemoglobin (HbA1c) Control, Diabetes Mellitus, Participatory Action Research, BAC Model